Prevalence of Erythrocyte Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in the Population of Western Turkey

Red cell glucose 6-phosphate dehydrogenase deficiency in the northern region of Turkey: is G6PD deficiency exclusively a male disease?

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive genetic defect that can cause hemolytic crisis. However, this disease affects both males and females. In Turkey, the frequency of this enzyme deficiency was reported to vary, from 0.25 to 18%, by the geographical area. Its prevalence in the northern Black Sea region of Turkey is unknown. The aims of this study were to assess the prevalence of G6PD deficiency in the northern region Turkey in children and adults with hyperbilirubinemia and hemolytic anemia. This report included a total of 976 G6PD enzyme results that were analyzed between May 2005 and January 2014. G6PD deficiency was detected in 5.0% of all patients. G6PD deficiency was significantly less frequent in females (1.9%, 6/323) than in males (6.6%, 43/653). G6PD deficiency was detected in 3.7% of infants with hyperbilirubinemia, 9.2% of children, and 4.5% of adults with hemolytic anemia. In both the newborn group and the group of children, G6PD deficiency was significantly more frequent in males. In the combined group of children (groups I and II), the proportion of males was 74% and 67% in all groups (P = .0008). In conclusion, in northern region of Turkey, G6PD deficiency is an important cause of neonatal hyperbilirubinemia and hemolytic crisis in children and adults. This study suggests that most pediatricians thought that G6PD deficiency is exclusively a male disease. For this reason, some female patients may have been undiagnosed.

Malaria in Turkey: successful control and strategies for achieving elimination

Turkey is located in the middle of Asia, Africa and Europe, close to Caucasia, Balkans and Middle East in subtropical climate zone. Malaria has been known since the early ages of human history and it was one of the leading diseases in Anatolian history, as well. Today, chloroquine-sensitive Plasmodium vivax is the only agent of autochthonous malaria cases in Turkey. The other Plasmodium species identified are isolated from imported cases of malaria. The most common vector of malaria in Turkey is Anopheles sacharovi followed by An. superpictus, An. maculipennis and An. subalpinus. In 2009, pre-elimination stage of Malaria Program was started due to dramatic decline in the number of malaria cases in Turkey (Total, 84; 38 autochthonous cases only in 26 foci in south-eastern Anatolia, and 46 imported cases; incidence: 0.1/100,000). As there were no detected cases of new autochthonous malaria in the first 8 months of 2010, elimination stage was started. The role of the persistent policies and successful applications of the Ministry of Health, such as the strict control of the patients using anti-malarial drugs especially chloroquine, avoidance of resistant insecticides, facilitation of access to patients via Health Transformation Program (HTP), establishment of close contact with the patients' families, and improvement of reporting and surveillance system, was essential. In addition, improvement maintained in the motivations and professional rights of malaria workers, as well in the coordination of field studies and maintenance of a decline or termination in vector-to-person transmission were all achieved with the insistent policies of the Ministry of Health. Other factors that probably contributed to elimination studies include lessening of military operations in south-eastern Anatolia and the lowering of malaria cases in neighbouring countries in recent years. Free access to health services concerning malaria is still successfully conducted throughout the country.